>Employed physicians in an integrated health system and plan (like Kaiser or Geisinger), in theory don't have to deal with those aspects as much, and can concentrate more on the patient.

"Employed" physicians no longer deal with patients, they are called customers. Helps to keep customers happy and physicians focused on the profit motive.

Wouldn't the profit motive be stronger for an independent physician since they actually directly profit, rather than facing indirect pressure based on your employer's profit motive?

Independent physicians are free to act as they see fit, some are very profit motivated, some aren't.

Employed physicians are pushed to be as profit motivated as their employer wants them to be, or they get canned.

> Independents (a majority of physicians)...

Is this still true?

It seems like the days of the independent physician are drawing to a close. Many independent practices have become physician groups which in turn have been bought by hospitals. (Perhaps specialists are still largely independent, but general outpatient medicine seems to have become largely corporate.)

Many physicians I know have a boss, and have to meet metrics about how many patients they see ever year in order to get their incentive bonus. Physicians who work for hospitals are viewed as "loss leaders", and find their appointment times squeezed to twenty, fifteen, or even twelve minutes per patient. (The idea is that for every n visits, a patient will be referred to a profitable service provided by the hospital.)

You can't be independent anymore and bear the cost of electronic records, so the options are to stop accepting insurance (cash only) or join a large practice, usually run by, or at least associated with, a hospital, for access to their records system.

Every physician deals with billing and insurance. EHR setup is trivial compared to the daily burden of using it.

Independents likely have it easier as their EMR are less complex and they have fewer people to coordinate with.

EMRs in general have little to do with patient care. They are glorified billing systems.

This would be interesting to see.

I know it's only anecdotal but my brother in law is a doctor at a large hospital (employed physician) and he sees patients 9-5 but he's at the hospital from 7am-8pm doing prep, research and patient notes. That also doesn't count the nights/weekends when he's on call for the ER (usually takes calls from home but occasionally has to go in too). He basically only sees his kids on the weekend.

I worked similar hours for a few years while coding and I expect he will (but hope he doesn't) burn out eventually. It's obviously not sustainable.

On the other hand employed physicians in an integrated health system have to deal with their bosses and lack control over their working conditions.

Hey, welcome to the working world of the rest of us. If this is the complaint, doesn't seem worthy of a WSJ article.

I realize from the comments here that I wasn't as clear as I intended. I conflated "employed" with "employed in an integrated system with a health plan." Having an integrated insurance plan run by the provider in theory aligns incentives to keep patients healthy rather than fight over billing.